O2D-MedNet: An Optimization-Aware Dual-Domain Framework for Robust Medical Image Segmentation

Medical image segmentation (MIS) remains challenging due to composite degradations and multi-scale geometric variations, which jointly impair lesion-background separability, structural consistency, and optimization stability. Existing single-stream frameworks entangle heterogeneous cues within a single representation pathway, while hybrid-stream approaches often rely on generic or static fusion, limiting effective coordination across domains and failing to explicitly address optimization instability. To overcome these limitations, we propose a new optimization-aware dual-domain framework for MIS (O2D-MedNet). First, a degradation-aware dualdomain interaction (DDI) module integrates Fourier - and Wavelet-domain features to suppress degradation-sensitive responses while preserving structural and fine-detail information. Second, a cross-backbone contour-guided fusion (CGF) module enables selective interaction between CNN-based local detail modeling and visual state-space-based global structure modeling, improving boundary accuracy and representation consistency. Third, a gradient-context optimization (GCO) strategy stabilizes training by adaptively adjusting learning dynamics based on loss trends and gradient statistics, mitigating instability caused by class imbalance and heterogeneous sample difficulty. Extensive experiments on six benchmarks demonstrate consistent improvements over state-of-the-art MIS methods across multiple imaging modalities. Further analyses confirm enhanced sensitivity, structural consistency, and optimization stability, validating the effectiveness of the proposed O2D-MedNet for robust MIS under heterogeneous conditions.